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All Journal Magna Neurologica
Retno Jayantri Ketaren
Department of Neurology, Siloam Hospitals Lippo Village, Tangerang, Indonesia
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Sturge - Weber Syndrome: A Glimpse into A Rare Clinical Diagnosis Retno Jayantri Ketaren; Jacob Christian Cenadi
Magna Neurologica Vol. 3 No. 2 (2025): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i2.1823

Abstract

Background: Sturge-Weber syndrome is a spectrum of neurocutaneous disorders characterized by angiomas involving the face, choroid, and leptomeninges. Patients present with the typical “port wine stain”, acute seizure onset, and increasing hemiparesis. Case: A 1-year-old female presented to the ED with a seizure that coincided with a fever. The patient had two generalized tonic-clonic seizures in a day, which lasted less than 5 minutes. Before this, the patient had a history of seizures that started at 6 months old. The patient had an erythematous patch covering the right side of her face, along with left-sided weakness and positive plantar reflex on the left foot. Head non-contrast MRI scan showed a hypointense lesion/blooming artifact in the right frontal lobe on T2FFE and a prominent vascular structure on the right frontal lobe, accompanied by the widening of multiple veins and sinuses. Discussion: Sturge-Weber syndrome is complete when both facial angioma and leptomeningeal involvement are present. Diagnosis is confirmed through clinical features, with seizures and hemiparesis correlating to imaging findings. In our patient’s case, a type I Sturge-Weber syndrome diagnosis was made. The patient was started on oral anticonvulsants and future controls. Conclusion: Sturge-Weber syndrome is a clinical syndrome with many neurological complications. The lack of specific treatment urges an early diagnosis, as it can affect the patient’s outcome.
Pediatric Epilepsy Surgery in A Drug-Resistant Epilepsy Patient Aggravated by SARS-CoV-2: A Case Report Edeline Samudra; Retno Jayantri Ketaren; Made Agus Mahendra Inggas
Magna Neurologica Vol. 3 No. 2 (2025): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i2.1882

Abstract

Introduction: Epilepsy is a manageable neurological disorder, but about one-third of cases are classified as drug-resistant epilepsy (DRE). DRE in pediatrics is more complex and may lead to cognitive function impairment, while surgery can offer seizure control in cases of focal DRE. Case: A 10-year-old male presented with a four-year history of recurrent seizures, thought to be caused by a left temporal cerebral cyst diagnosed five years earlier. During episodes, he experienced body stiffness, bilateral eye twitching, and drooling, with intact consciousness. After SARS-CoV-2 exposure, seizures became more frequent despite antiepileptic treatment, leading to partial resection of the left temporal lobe nine months later. Two years post epileptic surgery, he has become drug-responsive and achieved seizure control with symptomatic relief through medication. Discussion: Epilepsy is common in children, and DRE should be considered in cases of intractable epilepsy. Various factors can cause DRE, and in this patient, SARS-CoV-2 is thought to aggravate seizures by binding to ACE2 receptors in the central nervous system. This neural interaction may trigger reactive astrogliosis and neuroinflammation, disrupting the balance between glutamate and GABA levels. However, epilepsy surgery has been effective in improving the quality of life. Conclusion: Epilepsy surgery, either resective or non-resective surgery, is still rarely performed in Indonesia, while the management of DRE may require surgery. Although complete seizure freedom is not guaranteed, surgery can often convert DRE into a drug-responsive condition.
Unknown Risk Factor in Pediatric Ischemic Stroke: Challenges in A Developing Country Edeline Samudra; Retno Jayantri Ketaren
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2101

Abstract

Background: Stroke is a sudden neurological disturbance with high mortality rates in both children and older people. Pediatric stroke is rare but can lead to lifelong disability due to the immaturity of the brain, and its management can be challenging. Case: A 23-year-old female presented with a history of right-sided weakness and spasticity that began 11 years ago and improved over the past two years. Risk factors that could be excluded were ruled out, while congenital disorders could not be investigated due to financial constraints. Diagnosed with non-hemorrhagic stroke at age 12, an MRI revealed an old infarct in the left internal capsule. The absence of known risk factors underlying her ischemic stroke made a congenital disorder a plausible diagnosis. She was given botulinum toxin type A (BoNT-A) injections to manage spasticity, and her symptoms improved. In the past year, she developed mood disturbances and sleep difficulties, which were treated with quetiapine. Discussion: The pediatric brain is metabolically more active with higher cerebral blood flow demands, making it more susceptible to focal neurological injuries. Most pediatric strokes are ischemic, with numerous potential risk factors including cardiac issues, vasculopathy, coagulopathies, infections, and congenital disorders with vascular complications. Treatment for pediatric ischemic stroke is similar to that in adult cases. In this patient, BoNT-A injections reduced acetylcholine release, effectively treating the patient’s spasticity. Conclusion: Stroke can occur at any age, with pediatric strokes potentially resulting in worse outcomes. Therefore, thoroughly evaluating diverse potential etiologies, including congenital disorders, is crucial.
Co-Authors Edeline Samudra Jacob Christian Cenadi Made Agus Mahendra Inggas